Fungal infections are tough to treat

March 10, 2011|Suzy Cohen, Dear Pharmacist

Dear Pharmacist: One of my toenails has developed a yellowish-green fungus that won't go away. Can you help? — A.M., Boulder, Colo.

Dear A.M.: Toenail fungus (onychomycosis) is not merely an unsightly cosmetic problem. It sometimes causes physical pain, disfigurement or disability. Once you're infected, it spreads easily and is tough to get rid of.

This may shock you, but nail fungus is not a topical problem. You may see it on the surface, but those fungal spores are inside you, causing dozens of other seemingly unrelated health problems! Medications aren't usually effective long-term because they kill the fungus temporarily, but they don't improve the health of the host (you), meaning the left-over spores will just start multiplying in the host again. If you take medication, you should also change your diet and lifestyle habits in order to prevent the fungus from taking hold again. Step one is no more sugar or grains.

There is no shortage of drugs to kill the fungus. Some include nystatin, griseofulvin, ketoconazole, fluconazole, itraconazole and terbinafine. Depending on the medication, it could cost you several hundred a month, and side effects range from minor nausea to hair loss and possibly liver or heart failure, so make sure you remain monitored and take routine lab tests. Treatment could take up to a year. Sometimes people use a prescription nail lacquer called Penlac — I like this option because there are few, if any, side effects.

All these creams, sprays, and gels containing anti-fungal ingredients are intended for less challenging skin infections, such as ringworm, jock itch and athlete's foot. But you can certainly try them for toenail fungus. They're easy to find and easy to use, and they're a safe place to start. I think store-brand generic equivalents offer consumers an even better deal because generics always save you money.

The most promising natural option is 100 percent tea tree oil, an inexpensive, widely available antiseptic oil from Australia. Find it at any health food store and some pharmacies. Tea tree oil has anti-fungal properties because of the terpenoids.

One of my buddies has been applying tea tree oil daily to his nail fungus for 12 weeks, and the new growth is coming in normal. If you'd like to try tea tree oil, apply it every morning and night to dry nails. Dab it on the area and don't give up because it may take several months before you see results. In the unlikely event that it irritates your skin, discontinue use.

This information is not intended to treat, cure or diagnose your condition. Go to DearPharmacist.com.